Abstract: PACE therapy (Promoting Aphasia Communication Effectiveness) is a functional communication intervention procedure building on principles of conversation and multi-modal communication. It is a pragmatic intervention that captures the dynamic nature of communication, and provides flexibility to be applicable to a wide range of individuals with aphasia across a broad spectrum of language dififculties and verbal output. This presentation will provide the primary elements of PACE therapy, specific implementation strategies, video examples, and applications of PACE as a person-centered intervention. Additionally, treatment stimuli resources will be provided.
Summary:
The concept of Promoting Aphasia Communication Effectiveness (PACE) was developed in the late 1970s and 1980s as a means to incorporate more functional components into traditional naming therapy for aphasia (Davis & Wilcox, 1985; Davis, 2005). Since that time, PACE has undergone subtle iterations, while still maintaining the primary concepts and principles as originally developed. At the time of development, it was an abrupt paradigm shift to impairment-based, stimulation approaches typical of that time. In essence, PACE was designed with the main goal of improving communication. The concept, and the constructs, were influenced by the emerging, person-first, conversation-based therapies being developed at that time by Audrey Holland and Martha Taylor-Sarno, among others. It has since been identified as an intervention strategy for multiple types of aphasia (Marshall, 2001; Peach, 2001). It is designed as a tool that “models conversation…[and] contains elements of conversation that are missing in traditional direct stimulation or instruction” (Davis, 2005, p. 26). There have been various reports of “modified PACE” procedures and interventions (LeDorze, Croteau & Joanette, 1993; Carlomagno, 1994; Pulvermuller & Roth, 1991) while still maintaining the primary principles of PACE. These modifications to PACE are applicable to current inpatient, inpatient rehabilitation and outpatient clinical settings that provide services to individuals with aphasia. PACE therapy provides opportunities for clinicians to provide functional, patient-centered therapy. Because PACE is not dependent on a rigid algorithm, yet provides a generalized format for intervention, clinicians may find this a reasonable, effective tool to provide aphasia therapy, especially while trying to avoid “workbook”-type impairment based therapies. PACE can be customized to the individual client, and maintains focus on conversation and communication of new information. While there continues to be recurring interest in PACE therapy, there have also been misconceptions of PACE as evidenced by Davis (2005) and multiple conversations and interactions that the primary presenter has had with new and seasoned clinicians over the past year, many of which are consistent with misconceptions of PACE outlined by Davis (2005). In this presentation, focus will be on strategies and applications of PACE within the inpatient and outpatient setting that can be implemented readily and easily. Participants will be able to implement information gleaned from this session into their clinical practice upon return to their work environments. Additionally, relevant PACE intervention stimuli resources will be provided, including a compendium of open-access video stimuli, open-access still images, and also descriptions of readily available objects to be used. Video footage of PACE in clinical intervention contexts will be provided and reviewed with participants. Example goals and documentation forms will be provided as well.
Learning Objectives:
At the completion of this activity, participants should be able to:
State three primary assumptions that guide PACE therapy
State the four principles of PACE therapy
List three separate stimuli resources that can be used in PACE therapy